Biocompatible oral bandage, application and method of manufacture

ABSTRACT

Biocompatible adhesive protective dressings, and methods of manufacturing and using the same, having properties suitable for use on moist tissues such as gingiva. The dressing may include a flexible sheet, e.g. a metal foil, with an irradiated gamma radiation sensitive adhesive on one surface. The properties of gamma sensitive adhesives are modified by exposure to gamma radiation so as to increase their adhesiveness and volume. The dressing may be applied to human or animal tissue to protect the tissue from the environment, and retain autogenous and other substances at the application site. The dressing may be used at surgical sites or wounds.

BACKGROUND OF THE INVENTION

[0001] 1. Field of the Invention

[0002] The invention pertains to protective dressings, and moreparticularly to adhesive protective dressings that may be used withanimal or human tissue to promote healing, particularly of an oralcavity wound or surgical site.

[0003] 2. Description of Related Art

[0004] It is generally desirable to protect wounded human or animaltissues, particularly oral tissue after gingival surgery, e.g., aftertooth extraction. A recent surgical site or wound, in addition to beinguncomfortable or painful, is susceptible to infection. Further, lingualand masticatory action, saliva and fluid flow, and food and debrisentering an oral wound can delay clotting or dislodge a clot andinterfere with healing.

[0005] Typically, after oral surgery the surgical incision is oftensutured and a cotton dressing (gauze) or a periodontal pack is placed onthe surgical site. The dressing's primary purposes are to apply pressureto the wound to help stop bleeding, provide some protection againstcontaminants, and act as temporary physical barrier to the oralenvironment. However, a dressing that is made of an absorbent material,such as cotton or the like, has limited ability to prevent moisture andsaliva from reaching the surgical site and itself may become saturated,rendering it useless. Moreover, the dressing is held in place by eithercompression by the patient, e.g., biting down, or by wedging the packbetween adjacent teeth. These methods do not reliably hold the dressingin place and it may be dislodged by lingual and masticatory action, andin any event, does not provide an adequate seal to prevent particlesand/or moisture, e.g., saliva, from reaching the site. Such a dressingis only effectively used for perhaps a few hours after surgery.

[0006] It would be desirable to use a dressing that would preventmoisture from reaching a surgical site or wound, adequately seal thesite from the environment, be pliable and imporous, and be sufficientlyadhesive to the site to be reliably retained to it for sufficient timeto allow healing to begin without interference from the oralenvironment. In cases where the wound or surgical site has been sutured,the patient also may need to return to the surgeon's office at a laterdate to have them removed.

[0007] Numerous materials are known that are both moisture proof,imporous and biocompatible, so as not to not cause physical or chemicaldamage to the tissues. Such materials include, for example, metals,plastics, vinyls, and hydrogels. These materials are also available inpliable form, e.g., metal foil, such as tin or aluminum. Biocompatibleadhesives are also known and include waxes, powders, gums, polymers(such as acrylics) and other materials.

[0008] U.S. Pat. No. 1,550,425 to Burlew, which is hereby incorporatedby reference in its entirety, describes an adhesive covering forprotecting dental fillings in teeth from moisture. The covering consistsof a thin metal foil upon which is deposited a film or layer of paraffinthat is united to the foil by heat so as to resist separation. On theouter surface of the paraffin there is rolled or pressed a coating offinely ground gum tragacanth. Jelenko Company of Armonk, N.Y. sells sucha covering as Burlew™ Dryfoil™ and Burlew™ Orthofoil™. In particular,the Jelenko product is 99.8% tin foil. The Dryfoil™ has a thickness ofabout 0.00075 inches, while the Orthofoil™ has a thickness of about0.0013 inches. The slightly adhesive wax/powder surface allows the foilto adhere to dried teeth.

[0009] However, the Burlew covering possesses insufficient adhesivenessto adhere to gingival tissue, which is moist, and its limited thicknessprovides only minimal physical protection. In addition, it is notsterile, and thus not suitable for post-surgery wound protection.

[0010] Thus, it would be desirable for such a covering to have increasedcapability to seal protected tissues from the oral environment andincreased adhesiveness for retention. It would also be desirable toprovide the tissue with increased physical protection of the tissue. Itwould further be desirable that such a covering would be sterile. Inaddition, it would be desirable to reduce or eliminate the need forsuturing a wound or surgical site.

SUMMARY OF THE INVENTION

[0011] The present invention is directed to providing an adhesivedressing, particularly a gingival protectant having the aforementioneddesirable properties.

[0012] The invention is a biocompatible adhesive protectant covering orbandage for use with human or animal tissues, and methods of producingthe same. The invention comprises a flexible, pliable, ductile,imporous, moisture-proof, i.e., impervious to moisture, dressing with anadhesive for adhering the covering to tissues for temporary retentionand protection from moisture. The adhesive is suitable for both hard andsoft tissues, including moist gingival tissues in the mouth, as opposedto merely hard tissues. The protective covering is preferably easilyapplied to the tissues and occupies minimal space, which is beneficialin the mouth, allowing it to be opened and closed with ease whileeffectively preventing contact of the tongue or lips with the tissue.The dressing may be configured so as to be placed upon a surgical siteor wound.

[0013] The adhesive may comprise a gamma radiation sensitive adhesive.When the adhesive is gamma irradiated or otherwise exposed to gammaradiation, i.e., above normal background radiation levels, it undergoesphysical and chemical changes. These changes include an increase involume and adhesiveness. The degree of increased volume andadhesiveness, or tackiness, increases with increased irradiation. Theamount of irradiation of the adhesive protective covering may be varieddepending upon the amount of volume increase and adhesiveness desired.The irradiated adhesive may then be applied to tissue and adhere to it,and when utilized with a protective covering or “oral bandage,” adherethe covering to the tissue. The increased volume and tackiness mayassist the covering in preventing undesirable environmental elements,e.g., in the mouth, from reaching the tissue, and cushioning and/orprotecting the tissue from physical impact and contaminants.

[0014] The adhesive may be irradiated to a degree so that it will adhereto the tissue for a sufficient time for the tissue to significantlyheal. This includes moist tissues that are subject to mechanical forces.Thus, the adhesive, alone or in combination with a protective covering,protects the tissue to promote healing and to minimize the possibilityof blood clot breakdown, infection, or contamination, all of which mayresult in pain and discomfort.

[0015] Gamma radiation may also sterilize the adhesive and protectivecovering, thereby further decreasing the possibility of infection. Whensterilized in sealed packaging, the sterility may be maintained untiluse, which may be years later.

BRIEF DESCRIPTION OF THE DRAWINGS

[0016] The foregoing and other features of the present invention will bemore readily apparent from the following detailed description anddrawings of an illustrative embodiment of the invention where likereference numbers refer to similar elements throughout the several viewsand in which:

[0017]FIG. 1 shows a partially cutaway plan view of an adhesive dressingaccording to an embodiment of the invention;

[0018]FIG. 2 shows a schematic representation of adhesive dressings insterile blister packaging according to an embodiment of the invention;

[0019]FIG. 3 shows a schematic representation of a portion of a jaw witha tooth extraction socket;

[0020]FIGS. 4a and 4 b show schematic representations of the jaw of FIG.3 that has been prepared for application of a dressing according toembodiments of the invention;

[0021]FIGS. 5a and 5 b show schematic representations of the jaws ofFIGS. 4a and 4 b, respectively, with a dressing applied according toembodiments of the invention; and

[0022]FIG. 6 shows a schematic representations of the jaw of FIG. 3 inwhich an implant has been installed in an extraction socket according toan embodiment of the invention.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0023] As shown in FIG. 1, a wound or surgical protective dressing 1comprises an adhesive 2 placed on a covering material 3 that may act asa protective covering or bandage, such as, by way of example cloth,vinyl, metal foil, plastic, or hydrogel. The covering material 3 may maybe cuttable or reshapeable for any desired configuration, preferablyyieldable under finger pressure. Although the dressing 1 is shown asbeing sheet-like in shape, it may be provided in any desired shape, forexample, a strip or as a roll.

[0024] Preferably, the covering material 3 is selected to providedesired protective characteristics. For example, if it is desired tolimit the amount of moisture reaching the covered tissue, awater-resistant, waterproof or imporous material may be used, such as,for example, a foil, plastic, vinyl or hydrogel.

[0025] The adhesive may be any biocompatible adhesive havingcharacteristics suitable for adhering the protective dressing to thetissue. In one embodiment of the invention, the adhesive comprises thewax/powder adhesive of the Jelenko product described above, which may begamma irradiated to alter its physical and/or chemical characteristics.The adhesive may be gamma irradiated (by any means) sufficient to causethe desired property alteration, such as by a Cobalt-60 source. Thoseskilled in the art will recognize that if the protective covering is tobe irradiated along with the adhesive, e.g., during sterilization, itshould be of suitable material to perform its protective functionthereafter. In other words, those skilled in the art will be able toselect a covering whose functioning is not impaired, i.e., will notdeteriorate, upon exposure to the gamma radiation. An examples ofwater-resistant and imporous coverings that are not adversely affectedby gamma radiation are metal foils, such as tin or aluminum.

[0026] Referring now to FIG. 2, the one or more dressings 1, 8 may beplaced in packaging 4, e.g., conventional medical blister packaging,which may be sealed by seals 5, preferably hermetic seals. Although thepackaging shown includes six dressings, it will be understood that thepackaging can include any number of dressings of any size or combinationof sizes. Preferably, each dressing is individually sealed so that onedressing may be removed from the packaging 4 at a time withoutcontaminating other dressings. To this end, the packaging 4 may beprovided with perforations 6 or the like to facilitate separation andremoval of a single dressing.

[0027] The dressings 1, 8, along with the packaging 4, may be gammairradiated, which preferably, along with its seals 5, is not adverselyaffected by the radiation. The radiation permanently alters propertiesof the adhesive, such as adhesiveness and volume. The dressing may beirradiated to the degree necessary to achieve the desired adhesiveness,tackiness and volume increase depending upon the application. Thoseskilled in the art will recognize that the desired adhesiveness orvolume depends upon various factors, including, but not limited to, thetissue upon which the adhesive protectant will be used, the location ofthe tissue on or in the body, the type of injury or surgery to thetissue, the environment from which the tissue is to be protected, thedegree of protection against the environmental factors desired, the typeof protective covering to be used, if any, and the length of time forwhich the adhesive is required to perform its function, e.g., adhere thedressing (bandage) to the tissue. Those in the field will be able toassess the various factors and irradiate the adhesive to obtain thedesired characteristics. By way of example, irradiation of the adhesivewith at least about 25 kGy of gamma radiation achieves an increase inadhesiveness and volume so as to adequately adhere to and protectsurgical tissues from moisture in the mouth, e.g., gum or gingivaltissue.

[0028] In certain embodiments of the invention, the adhesive, along withany protective covering, is sterilized. Preferably, the adhesive andcovering are gamma irradiated with at least about 25 kGy, and morepreferably between about 25 kGy and 50 kGy. In FIG. 2, where theprotective dressings 1, 8 are sealed in the packaging 4 prior toirradiation, sterilization also sterilizes the packaging, so thatsterility of the dressing is maintained until the packaging is openedfor use.

[0029] Referring now also to FIG. 3, a jaw 10 containing teeth 11, 12has had a tooth (not shown) extracted, leaving an extraction site 13with an extraction socket 14, which may be generally conical in shape,in the jaw bone 15 below the gum tissue 16. Although an extraction siteis shown for a tooth having only one root, i.e., a bicuspid, thoseskilled in the art will understand that the invention may be utilized onany extraction site within the mouth, including teeth having two, threeor four roots. After extraction, the jaw bone 15 and incised gum tissue16 are exposed to the environment in the mouth, which in addition topossibly causing pain to the patient, can lead to infection and debrisin the extraction site and thereby delaying or preventing healing.

[0030] In order to place a dressing upon the surgical site or wound, aportion 7 of the blister packaging 4 is opened and an irradiatedadhesive dressing 8, preferably sterilized (e.g., with between 25 and 55kGY of gamma irradiation), is removed. In this manner, the otherdressings, e.g., 1, in the packaging 4, remain sealed and sterilized.

[0031] Referring to FIGS. 4a, 4 b, 5 a, and 5 b, the dressing 8 may betrimmed to a desired size and shape, preferably matching the contoursand dimensions of the area to be covered, e.g., the gingival tissue atand adjacent to the wound site. It is also preferable that the dressingnot overly interfere with oral function, e.g., speaking. For example, inFIG. 4a, the dressing 8 may be trimmed to have contoured lateral edges17 a, 17 b so that the dressing 8 fits between the adjacent teeth 11, 12and generally follows the contours 18, 19 of the teeth 11, 12 andgingival tissue 16 adjacent to the extraction site 13, i.e., thedressing 8 contacts soft tissue, e.g., gingiva, only. In the embodimentshown in FIG. 4b, protective dressing 20, whose composition may besimilar to dressing 8, has a contoured edge 17 c so as to generallyfollow the contour 18 of tooth 11, but the other lateral edge 17 d ofthe dressing 20 has not been contoured or trimmed and may overlapadjacent, e.g., one or two, teeth. Alternatively, the dressing may notbe trimmed or multiple dressings may be used.

[0032] In order to place the dressing 8, 20 on the extraction site 13,the dressing 8, 20 is positioned over the extraction site 13 with theadhesive 2 facing toward the soft tissue. The dressing 8, 20 is appliedagainst the gum tissue 16, preferably on the buccal and lingual sides.It may also extend over adjacent teeth, e.g., 12, if desired by thesurgeon or operating nurse.

[0033] Preferably, the dressing 8, 20 is applied to the jaw 10 toprovide optimum protection to the surgical site 13, i.e., to isolate thesurgical site from the oral environment. For example, dressing 8 may beconfigured upon placement so that a portion 21 of the dressing 8, 20 isapplied to the buccal side 22 of the jaw 10, and another portion 23 ofthe dressing is applied to the lingual side 24 of the jaw 10 (FIGS. 5a,5 b). In addition, in embodiments where the dressing overlaps adjacentteeth, as in FIGS. 4b and 5 b, the overlapping portion 25 of thedressing 20 is configured to generally conform to the shape of tooth 12.Also preferably, the adhesive 2 may be distributed on the area so thatif assists the covering 3 in sealing the site 13 from the oralenvironment.

[0034] Further, in a preferred method of applying the dressing, beforethe dressing is applied, the gingiva 16 surrounding the extraction site13 is dried in order to increase initial adhesion of the dressing to thegum 16. This may be accomplished with cotton swabs and/or air, e.g.,compressed air. This drying may assist in accurate placement of thedressing on the jaw 10. Also, for certain types of adhesives, forexample, waxes and powders, the adhesive 2 is preferably moistenedbefore application, e.g., with water or sterile saline so as to aidinitial adhesion and placement.

[0035] With the adhesive dressing applied to the surgical site or wound,saliva, food, and oral debris are prevented from reaching the gingivaltissue. It is also protected from masticatory and lingual tongue actionwhile healing occurs. The adhesive protective dressing also helps retainblood at the surgical site, which clots and helps to stop bleeding, thusreducing or eliminating the need for suturing the gum tissue. Autogenousbone cells, present in the retained blood from the marrow at the socketperiphery, clot and assist in regeneration of bone. The adhesivecovering helps prevent this beneficial blood material from beingdislodged, broken down, or washed away in the oral environment. Thisclot protection also occurs when a bone graft material, e.g., Bioplant®HTR®, available from Bioplant, Inc. of South Norwalk, Conn. has beenmixed with the bleeding marrow and placed into the extraction socket, asdescribed below.

[0036] The dressing 8, 20 may be left on the gum tissue until sufficienthealing has occurred, which may be up to seven days or longer, andpreferably is about one day to one week. If necessary, adhesiveretention of the dressing 8, 20 may be aided by use of a periodontal gumpack 26 (FIGS. 5a & 5 b). The periodontal pack 26 may be an absorbent,e.g. cotton, material. It may be placed over the dressing 8, 20 so thatthe periodontal pack 26 is held in place by the wedging action ofadjacent teeth 11, 12, e.g., by wedging the pack 26 between the teeth11, 12.

[0037] Preferably, the adhesive's characteristics allow the dressing tobe removed from the surgical site without excessive difficulty and anyadhesive remaining on the tissues also may be removed. For example, theadhesive disclosed by Burlew, either in irradiated or non-irradiatedstate, permits the dressing to be removed from the site without tearingof the dressing or excessive pulling on the tissues, blood clot/graftmaterial, or implant, which can cause pain or damage. Any adhesiveremaining on the tissues may be removed mechanically, e.g., gentlescraping, or will be removed by natural oral function, e.g., naturalsaliva flow, eating, drinking, and/or lingual action (speaking). As willbe recognized by those skilled in the art, there afre various knownbiocompatible adhesives exhibiting such properties, e.g., water-solublewaxes and gums such as gum tragacanth.

[0038] Although the above describes one method of utilizing theinvention at a wound or surgical site, those skilled in the art willrecognize that many variations on the above technique are contemplatedby the invention. For example, as shown in FIG. 6, at the toothextraction site 13 or other site where bone tissue is affected, bleedingmarrow may be collected and mixed with graft material 27, e.g., form apaste. This paste may then be placed onto the bone, e.g., in theextraction socket 14. The graft material or paste 27 is, preferably, atleast in part, retained by the dressing 8, 20, which is placed over thetissue as earlier described. The blood/graft mixture or paste promotesclotting, healing, and bone regeneration.

[0039] The invention contemplates that any suitable graft material maybe utilized with a bone tissue wound or surgical site, as would be knownto those in art. Examples of such graft material include, but are notlimited to, autogenous (from the surgical site or other hard tissue ofthe patient), xenograft (e.g., bovine), allograft (human derivatives),and alloplast (e.g., ceramic or plastic) materials. Various alloplastmaterials are disclosed in U.S. Pat. No. 4,536,158 to Bruins and Ashman;and U.S. Pat. Nos. 4,535,485, 4,547,390 and 4,728,570 to Ashman et al.,which cover the Bioplant® HTR® material described above. Theaforementioned patents are incorporated herein in their entirety.

[0040] Referring again to FIG. 6, in yet other embodiments of theinvention, the adhesive protective dressing 8 is placed over the site ofa recently installed dental implant 28. Dental implants are well-knownin the art and may be installed into the edentulous area of a patient'sjaw bone to anchor a prosthesis. It is also known that an implant may beinstalled immediately after a tooth extraction in order to avoid laterinvasive procedures, which may require removal of bone that has regrown,and to prevent bone resorption at the extraction site, which commonlyoccurs after tooth extraction. Although FIG. 6 shows a submergiblethreaded cylinder-type implant, it will be understood that any type ofsuitable implant may be used, which may be selected for, among otherreasons, the location of the extraction and the profile and condition ofthe anchoring bone. Generally, extraction sockets tend to be conical inshape, and preferably, cylindrical-type implants, or more preferably,conical or U-shaped implants, such as those disclosed in U.S. Pat. No.4,521,192 of L. I. Linkow, U.S. Pat. No. 2,609,604 of B. F. Sprague, andSer. No. 09/248,079 of Ashman et al. which are incorporated by referencein their entirety, may be utilized in order to more closely fit thedimensions of the extraction site. In addition, the area around theimplant 28 in the extraction socket 14 may be backfilled with the bonegraft material mixture 27 to promote bone regrowth, as described above,which assists in retaining the implant 28.

[0041] Once the implant 28 is installed in the bone, the dressing 8 maybe applied to the extraction/implant site 13 in the manner discussedabove. The dressing 8 retains the bone graft material mixture 27 andblood at the extraction/implant site 13, and protects it from the oralenvironment. Due to the retentive/protective properties of the dressing8, the suturing of the gum or gingival tissue 16 normally required afterimplant installation in a two-stage or a single-stage implant proceduremay be avoided or minimized. By way of example, the protective adhesivebandage may be utilized alone, i.e., without sutures, or in addition tosutures to further protect the surgical area. This may reduce oreliminate the need to have to later reopen the gum 16 to install anabutment or other prosthetic component onto the implant 28, resulting inless surgical trauma to the patient.

[0042] Those skilled in the art will recognize that the materials andmethods of the present invention will have various other uses inaddition to the above described embodiments. They will appreciate thatthe foregoing specification and accompanying drawings are set forth byway of illustration and not limitation of the invention. It will furtherbe appreciated that various modifications and changes may be madetherein without departing from the spirit and scope of the presentinvention, which is to be limited solely by the scope of the appendedclaims.

What is claimed is:
 1. A protective dressing comprising: a coveringmaterial; and a gamma irradiated, gamma radiation sensitive adhesivelocated on one side of said covering material, said adhesive having beenirradiated with gamma radiation in an amount sufficient to alter itsadhesive characteristics.
 2. The protective dressing of claim 1, whereinthe amount of gamma radiation is at least about 25 kGy.
 3. Theprotective dressing of claim 2, wherein said amount of gamma radiationis between about 25 kGy and about 50 kGy.
 4. The protective dressing ofclaim 1 wherein said protective dressing is sterilized.
 5. Theprotective dressing of claim 1 wherein said covering material issubstantially imporous and moisture-proof.
 6. The protective dressing ofclaim 5 wherein said covering material is selected from the groupconsisting of metal foil, plastic, vinyl, and hydrogel.
 7. Theprotective dressing of claim 6 wherein said metal foil is selected fromthe group consisting of tin and aluminum.
 8. A protective dressing forprotecting gingival tissue comprising a covering material and anadhesive on one side of said covering material, said adhesive beingadherable to said gingival tissue, said protective dressing beingconfigured for application thereto.
 9. The protective dressing of claim8, wherein said covering material has a sheet-like form, said coveringmaterial being configurable so as to generally conform to contours ofsaid gingival tissue.
 10. The protective dressing of claim 9, whereinsaid covering material is pliable and ductile.
 11. The protectivedressing of claim 8, wherein said adhesive includes a gamma-irradiatedgamma radiation sensitive adhesive.
 12. The protective dressing of claim8 wherein said protective dressing is sterilized by gamma radiation. 13.A method of protecting gingival tissue comprising applying aself-adhesive protective dressing to said gingival tissue.
 14. Themethod of claim 13, wherein said applying step includes applying saiddressing such that a substantial portion thereof in is contact with saidgingival tissue.
 15. The method of claim 13, further including the stepof configuring said protective dressing so as to substantially conformto contours of said gingival tissue where said protective dressing isapplied thereto.
 16. A method of protecting a a surgical site ingingival tissue from the oral environment comprising: providing asterile protective dressing comprising a flexible sheet-like coveringmaterial and an adhesive suitable for adhering to said gingival tissueon one side of said covering material; orienting said protectivedressing so that said adhesive faces said gingival tissue; applying saidprotective dressing to said surgical site, wherein said protectivedressing adheres to at least a portion of said gingival tissue adjacentto said surgical site.
 17. The method of claim 16 further including thestep of sterilizing said protective dressing with gamma radiation beforesaid orienting step.
 18. Method of claim 17 wherein said sterilizingstep includes irradiating said protective dressing with about 25 kGy toabout 50 kGy of gamma radiation.
 19. The method of claim 16 furtherincluding configuring said protective dressing such that said protectivedressing substantially conforms to contours of said gingival tissueadjacent to said surgical site.
 20. The method of claim 16, wherein saidsurgical site includes a tooth extraction socket and further includesthe step of placing graft material into said extraction socket beforesaid applying step.
 21. The method of claim 20, further including thestep of installing a dental implant in said extraction socket beforeplacing said graft material.
 22. The method of claim 20, wherein saidapplying step includes applying said protective dressing such that saidprotective dressing at least substantially retains said graft materialin said extraction socket.
 23. The method of claim 16, further includingwedging a periodontal gum pack between teeth adjacent to said surgicalsite and against said protective dressing to assist said adhesion ofsaid protective dressing to said gingival tissue.
 24. The method ofclaim 16, further including allowing said protective dressing to remainapplied to said surgical site until at least substantial healing thereofhas occurred.
 25. The method of claim 16, wherein said applying stepincludes applying said protective dressing so as to at leastsubstantially isolate said surgical site from said oral environment. 26.A protective dressing for protecting gingival tissues comprising: metalfoil; and an adhesive on one side of said metal foil comprising paraffinand gun tragacanth, wherein said adhesive has been irradiated with atleast about 25 kGy of gamma radiation.
 27. A sterile surgical packagecomprising at least one sterilizible protective dressing sealed insterilizible medical packaging, said at least one sterilizibleprotective dressing comprising a sterilizible covering material and agamma radiation sensitive adhesive located on one side of said coveringmaterial, said package having been sterilized with about 35 kGy of gammaradiation.
 28. The package of claim 27, wherein each of said at leastone sterilizible protective dressing is separately sealed in saidsterilizible medical packaging.
 29. A method of providing a sterileprotective adhesive dressing comprising the steps of: providing at leastone sterilizible protective dressing sealed in sterilizible medicalpackaging, said at least one sterilizible protective dressing comprisinga sterilizible covering material and gamma radiation sensitive adhesiveon one side of said sterilizible covering material; and sterilizing saidat least one sterilizible protective dressing with about 25 kGy to about50 kGy of gamma radiation.
 30. The method of claim 29, wherein each ofat least one sterilizible protective dressing is separately sealed insaid sterilizible medical packaging.